Association between short inter-pregnancy interval and placenta previa and placenta accreta spectrum with respect to maternal age at first cesarean delivery

Abstract

Objective

To explore the association between inter-pregnancy intervals and placenta previa and placenta accreta spectrum among women who had prior cesarean deliveries with respect to maternal age at first cesarean delivery.

Methods

This retrospective study included clinical data from 9981 singleton pregnant women with a history of cesarean delivery at 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017. The study population was divided into four groups (<2, 2–5, 5–10, ≥10 years of the interval) according to the inter-pregnancy interval. The rate of placenta previa and placenta accreta spectrum among the four groups was compared, and multivariate logistic regression was used to analyze the relationship between inter-pregnancy interval and placenta previa and placenta accreta spectrum with respect to maternal age at first cesarean delivery.

Results

Compared to women aged 30–34 years old at first cesarean delivery, the risk of placenta previa (aRR, 1.48; 95% CI, 1.16–1.88) and placenta accreta spectrum (aRR, 1.74; 95% CI, 1.28–2.35) were higher among women aged 18–24. Multivariate regression results showed that women at 18–24 with <2 years intervals exhibited a 5.05-fold increased risk for placenta previa compared with those with 2–5-year intervals (aRR, 5.05; 95% CI, 1.13–22.51). In addition, women aged 18–24 with less than 2 years intervals had an 8.44 times greater risk of developing PAS than women aged 30-34 with 2 to 5 years intervals (aRR, 8.44; 95% CI, 1.82–39.26).

Conclusions

The findings of this study suggested that short inter-pregnancy intervals were associated with increased risks for placenta previa, and placenta accreta spectrum for women under 25 years at first cesarean delivery, which may be partly attributed to obstetrical outcomes.

Keywords:

• Placenta previa
• placenta accreta spectrum
• inter-pregnancy interval
• maternal age
• cesarean delivery

Acknowledgments

We would like to thank LetPub for its linguistic assistance to edit and proofread this manuscript.

Ethical approval and consent to participate

This study was approved by the Medical Ethics Committee of Guangzhou Medical University with Medical Research No. 2016 (0406) approved on 6 April 2016. All the methods were performed in accordance with the relevant guidelines and regulations, and informed consent was obtained from all participants.

Consent for publication

Not applicable.

Author contributions

YL: propose ideas, data analysis, writing, review and editing. LZ: data analysis, review and editing. LH, YL, JC: propose original questions, review and editing. SB, MH, HT, SL, JL and SG: investigation, data collection, and visualization. JJ, SW, ZW, YC, SW, XX, LF, XZ, YZ, QZ, HQ, LZ and HL: investigation, and resources. LD, and DC: supervision, project administration, and funding acquisition.

Disclosure statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets generated and/or analyzed during the current study are available in the Population Health Data Archive (PHDA) (https://www.ncmi.cn/). Data are also available from the authors upon reasonable request.

Additional information

Funding

This study was supported by grants from the National Natural Science Foundation (No. 82071652 and 81830045) and the National Key R&D Program of China (No.2016YFC1000405, 2017YFC1001402, and 2018YFC1002902), General Program of Guangdong Province Natural Science Foundation (No. 2021A1515011039). The funding sources had no such involvement.